Background:
Complex emergencies that follow war and natural disasters have an impact on not only the individual but also on the family, community and society. Just as the mental health effects on the individual psyche can result in nonpathological distress as well as a variety of psychiatric disorders, massive and widespread trauma and loss can impact on family and social processes as well as the collective unconscious causing changes at the family, community and societal levels.
Methods:
This ecological study used qualitative methods of Participatory Action Research in Cambodia and Northern Sri Lanka, while involved in community mental health programmes among the Tamil and Khmer communities. Participant observation, key informant interviews and focus group discussion with community relief and rehabilitation workers and officials were used.
Results:
Fundamental changes in the functioning of the family and the community included the dynamics of single-headed families, lack of trust among members, and changes in significant relationships (mother-child), and childrearing practices. Communities were more dependent, passive, silent, without leadership, mistrustful and suspicious. Additional adverse effects included the breakdown in traditional structures, institutions and familiar ways of life, and deterioration in social norms and ethics. On the positive side, the study observed the emergence of community organizations, enhanced female role and leadership, and a decrease in suicide rates.
Conclusions:
Exposure to conflict, war and disaster impact on family and community dynamics resulting in changes at a collective level. Relief, rehabilitation and development programmes will need to use integrated multilevel approaches.
